Comparison of The Success of Single Dose Versus Multiple Dose Methotrexate in Ectopic Pregnancy with β-HCG Level 2000-5000 MIU/Ml

Abstract

Objectives: To compare the success of single dose versus multiple dose methotrexate in ectopic pregnancy with β-HCG level 2000-5000 mIU/mL.

Methodology: This randomized controlled trial. Obstetrics and Gynecology unit, PIMS Hospital, Islamabad from15th December 2016 to 14th June 2017. A total of 100 patients with ectopic pregnancy, 18 to 40 years of age were included. Patients with ruptured ectopic pregnancy, viable intrauterine pregnancy, renal failure, CLD and hypersensitivity to methotrexate were excluded. All patients were divided into two groups i.e. group A and B by random number tables. Group A patients were given single intramuscular injection of methotrexate in a dose of 50mg/m2 on presentation. Group B patients were given intramuscular injection of methotrexate in a dose of 50mg/m2 on presentation and 2nd dose was given on day 4. Success was measured after one week.

Results: Mean age was 30.93 ± 6.04 years. Mean gestational age was 7.39 ± 2.36 weeks. The mean baseline β-hcg levels in group A was 3045.63 ± 688.64 mIU/L and in group B was 3032.13 ± 666.28 mIU/L. Success (> 15% lowering of β-hcg levels from baseline at the end of one week) was seen in 90.0% in group A (single dose methotrexate) and 74.0% in group B (multiple dose methotrexate) with p-value of 0.037.

Conclusion: This study concluded that success rate of single dose of methotrexate in ectopic pregnancy with β-HCG level 2000-5000 is higher compared to multiple dose methotrexate.